Provider Demographics
NPI:1356112742
Name:TRAN, JUSTIN R (PT, DPT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:R
Last Name:TRAN
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-1723
Mailing Address - Country:US
Mailing Address - Phone:626-241-4980
Mailing Address - Fax:
Practice Address - Street 1:301 N LAKE AVE # 3201
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4107
Practice Address - Country:US
Practice Address - Phone:626-568-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3054012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic